OBJECTIVE Although abnormalities of neural circuits involving the cortex, striatum, and thalamus are hypothesized to underlie Tourette's disorder, the neuronal abnormalities within components of these circuits are unknown. The purpose of this study was to examine the cellular neurochemistry within these circuits in Tourette's disorder using proton magnetic resonance spectroscopy, a method that has not previously been used in neurobiological investigations of the disorder. METHOD Proton magnetic resonance spectroscopic imaging examinations were conducted in 25 males with Tourette's disorder (age 10.9 +/- 2.0 years) and 32 male comparison subjects (age 11.5 +/- 2.7 years). Spectra from frontal cortex, caudate nucleus, putamen, and thalamus were analyzed, and N-acetylaspartate, creatine, choline, myoinositol, and glutamate + glutamine were quantified and compared between the groups. RESULTS Patients with Tourette's disorder demonstrated a reduction in N-acetylaspartate and choline in the left putamen, along with reduced levels of creatine bilaterally in the putamen. In the frontal cortex, patients had significantly lower concentrations of N-acetylaspartate bilaterally, lower levels of creatine on the right side, and reduced myoinositol on the left side. CONCLUSIONS The results of this study suggest compromised neuronal integrity and deficits in density of neuronal and nonneuronal cells in components of the neural circuits implicated in Tourette's disorder.

OBJECTIVE:To describe the development of the Thought Disorder Questionnaire (TDQ), including data on reliability and validity, and to explain the questionnaire's feasibility and diagnostic accuracy.METHODS:The TDQ has 6 scales, each with 10 items (on a scale from 0 [for never] to 4 [for always]). The 6 scales measure content of thought, control of thought, orientation, perception, fantasy, and symptoms.RESULTS:The TDQ is a reliable 60-item, self-report questionnaire that measures the quantity and quality of disordered thinking in patients with mental disorders. It has established reliability and validity.CONCLUSION:The TDQ's clinical and research utility remains to be determined.

This introduction to the Special Section on Cognitive Science and Psychological Assessment begins with a brief overview of cognitive science and its interface with the clinical assessment of cognitive functioning. Concepts and themes permeating the articles in this section are then taken up. Included are cognitive-model architectures and model parameters, differential emphasis on efficiency versus content of cognition, and implementation of stochastic and dynamical aspects of cognitive processes. Selected distinguishing attributes of the respective contributions are highlighted.

Vulnerability-stress models suggest that training in specific stress management techniques should yield benefits to those suffering from schizophrenia and related disorders. In this paper, we describe an evaluation of the impact of adding a stress management program to other medical and psychosocial interventions for such patients. Outcomes were compared for 121 patients randomly assigned to receive either a 12-week stress management program with follow-up sessions or participation in a social activities group. The two treatment conditions did not differ in levels of symptoms, perceived stress or life skills immediately after completion of treatment or at 1-year follow-up. Patients who received the stress management program did have fewer hospital admissions in the year following treatment. This effect of stress management was most apparent for those who showed high levels of attendance for treatment sessions. It was concluded that training in stress management may provide patients with skills for coping with acute stressors and reduce the likelihood of subsequent acute exacerbation of symptoms with need for hospitalization.

This article begins with a guiding schema of relations among cognitive science, clinical science, and assessment technology. Emphasis is placed on stochastic modeling of cognitive processes. Basic models are adjusted so as to parsimoniously accommodate performance deviations occurring with psychopathology. Modified portions of models indicate functions affected by disorder, whereas portions remaining intact indicate spared functions. Findings from clinical cognitive science are applied to the individual case using Bayesian procedures. Methods are instantiated with respect to cognitive psychopathology of paranoid schizophrenia. The authors address observations and issues arising from this application, including integration of these methods with current assessment practices.

Salient commonalities and distinctions of the set of contributions to this special section are synthesized and discussed. The examination provides a springboard for observations on future developments in cognitive-science applications. Issues considered include imminence and nature of clinical implementation, prediction of selected client transactions outside the assessment context, integration with complementing modes of clinical assessment, and reciprocal information sharing by clinical and nonclinical cognitive scientists.

Two studies examined the declining of memory functions in normal elderly persons using the Yokota memory test (YMT), which includes 15 items concerning verbal and non-verbal memory functions. In the first study, 552 subjects over 40 years of age in five age groups were examined. Factor analysis revealed that YMT consisted of two factors pertaining to short-term/working memory, and two factors pertaining to long-term memory. It is suggested that the former was more affected than the latter, with aging. In the second study, YMT was examined in relation to the revised version of Hasegawa dementia scale (HDS-R), which was the most popular intelligence scale for the elderly in Japan. As a result, memory functions differentially declined with the decreasing score of HDS-R, which suggests that memory functions differentially declined with progressive risk of dementia.

Dynamic properties aligned with temporal interactions of stress, coping, and related variables are presented. Observations surrounding simple unidimensional systems are used to introduce more comprehensive systems of multidimensional interactions. Dimensions include collective levels of environmental stressors, levels of organismic stress arousal, coping-related cognitive efficiency, and engagement in selected coping activity. Changes in the relative impact of one dimension on another with the progression of lime also are accommodated. Important prototypical features of dynamic systems pertinent to the present substantive domain are noted. Relations of dynamic-systems models to other formal treatments of stress-coping variables then are discussed. Finally, avenues and issues of empirical testing are presented. It is concluded that hurdles to crafting valid multidimensional dynamic systems are justified by the obtained explicitness of intervariable structures and specificity of variable trajectories over time.

Scenario descriptor and laboratory studies evaluated a decision-theoretic model of stress arousal and coping propensity composed of 2 stress expectancies; namely, expected stress given engagement in coping activity and expected stress given nonengagement in coping activity. The model predicted (a) that coping propensity would vary inversely with the ratio of the first stress expectancy to the second and (b) that stress arousal would vary with the lesser of the 2 stress expectancies. It was also predicted that the smallest stress expectancy would dictate coping activity and that the proximity of the stress expectancies would engender stressing response conflict. Results supported the first hypothesis when differences in ratio values were salient. The second hypothesis also was supported, but in the scenario descriptor study only. Proximity of stress expectancies as sources of stress arousal received little or no support.

This article presents a formal, mathematical account of relations between response times on simple cognitive tasks and content of complex judgments involving multiple stimulus dimensions for people with schizophrenia. Changes in multidimensional :judgments were viewed as the result of interference from increased stages of encoding with respect to the individual dimensions. Information on dimensional properties encoded earlier in a judgment trial was considered to:be more susceptible to loss over the rest of the trial, because of a larger number of encoding-stages applied to the remaining dimensional properties. Model predictions were tested with samples-of paranoid and nonparanoid schizophrenic participants and controls. Unidimensional encoding speed was assessed by reaction times in an explicit similarity ratings task, and multidimensional judgment content was assessed by the relative importance of different stimulus dimensions to participants' ratings in an implicit similarity ratings task. Results support validity of the model.

Background: Past 1H magnetic resonance spectroscopy (MRS) studies of the temporal lobe in schizophrenic patients have shown decreased levels of N-acetylaspartate (NAA) suggesting reduced neuronal density in this region. However, the measured volumes have been large and included contributions from mostly white matter. Methods: Short echo 1H MRS was used to measure levels of NAA and other metabolites (i.e., glutamate and glutamine) from a 6 cm3 volume in the left mesial-temporal lobe of 11 first-episode schizophrenic patients and 11 healthy control subjects of comparable age, gender, handedness, education, and parental education levels. Spectra were quantified without operator interaction using automated software developed in our laboratory. Metabolite levels were normalized to the internal water concentration of each volume studied. Images were also obtained to determine temporal lobe gray and white matter volumes. Results: No significant differences were found between levels of NAA or other metabolites, or gray and white matter volumes, in first-episode schizophrenic patients and comparison subjects. Conclusions: Since the volume studied was small compared to previous studies and contained mostly gray matter, this result suggests consequential NAA decreases may be restricted to regions of white matter.

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Although addressed to diverse issues in clinical assessment, a number of common themes run through the preceding contributions. This discussion draws out conceptual, quantitative, and methodological points of overlap. and it also highlights certain distinctives affecting immediacy of application to applied assessment problems. It is noted that some methods lend themselves to rather direct application, whereas others require a degree of groundwork in the setting where they are to be used prior to implementation with individual cases. The placement of material from each contribution within formal theory is underscored, and potential returns on this investment are examined briefly.

This article provides a basic description of stochastic process models and their applicability to problems in assessment psychology. Such models accommodate inevitable uncertainty in prediction, hence their designation as stochastic. They also formally incorporate the variable of time. The dynamic aspects of the models are examined, in terms of the specific time, and time-related variables they accommodate. Distinctions are made between continuous- and discrete-time models, as well as between parametric and nonparametric characterization of probability distributions associated with clinically important phenomena. Such phenomena are wide ranging and include remission of florid symptomatology, debilitation in cognitive functioning, clients' responding to items on psychometric inventories, and clients' maintenance of therapeutic compliance.

The relevance of quantitative models of probabilistic processes to clinical phenomena that unfold over time is discussed. Examples of such phenomena include remission processes, accumulation of objective cost and subjective stress of treatment delay, and psychopathology-related deviations in cognitive operations. Provision is made for time as a continuous or discrete variable. The discourse is developed with the use of a representative mathematical model. Extraction of information on time-related aspects of clinical transactions is described. The presentation is extended to indicate how process models can be used with established assessment methods. Challenges to the application of process models in clinical-assessment settings, and potential avenues of resolution, are put forth. It is contended that stochastic quantitative models may represent the premier analytic tack to capturing genuinely dynamic features of clinical processes.

OBJECTIVEIt is likely that the corpus striatum is involved in obsessive-compulsive disorder (OCD). Prior studies have inconsistently found alterations in caudate volumes in patients with OCD. This study was undertaken in the hope that N-acetylaspartate and volumetric measures together would elucidate the presence and nature of corpus striatum volumetric abnormalities in OCD.METHODThirteen patients meeting the DSM-IV criteria for OCD, who had been medication free for a minimum of 6 weeks, and 13 psychiatrically normal matched comparison subjects participated in the study. Short echo 1H magnetic resonance spectroscopy (1H-MRS) was used to measure levels of N-acetylaspartate and several other cerebral metabolites from a 4.5-cm3 volume in the left corpus striatum of all 26 subjects. Metabolite levels were estimated by fitting the time domain spectroscopy data with a noninteractive computer program. Volumes of the left and right head of the caudate nucleus in each subject were determined by semiautomatic segmentation of the volumetric images.RESULTSN-Acetylaspartate levels from the left corpus striatum were significantly lower in the patients with OCD than in the comparison subjects. There were no differences in either left or right caudate volume between the two groups.CONCLUSIONSDespite the lack of differences in caudate volumes between the OCD patients and the comparison subjects, the lower level of N-acetylaspartate in the left corpus striatum of the patients suggests reduced neuronal density in this region. Inconsistent volumetric findings among prior studies may reflect a poorer sensitivity of magnetic resonance imaging morphometry for detecting neuronal loss compared with 1H-MRS measurement of N-acetylaspartate.

In a recent study, De Brabander and Hellemans (1996) reported that stress (somatic complaints) was inversely related to scores on personality scales of “thrill-and-adventure sensation seeking” and “internal locus of control.” These observations, useful in their own right, are of further value when examined in the light of mathematical models of stress and decisional control. It is suggested that diminished stress associated with higher scores on these scales may result from increased engagement and reduced aversiveness of cognitive demands mediating reduction of threat under conditions of decisional control.